AGROCHEMICALS AND THEIR IMPACT ON HUMAN HEALTH

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1 AGROCHEMICALS AND THEIR IMPACT ON HUMAN HEALTH An analysis of pesticide use and incidences of diseases in the region of Rincón de Santa María by: Kesner Dabady and Pierre Tulk ENVR 451: Research in Panama - Final Report (April 2015) Submitted to: Dr. Ana Spaldings 1

2 CONTACT INFORMATION Home institution: McGill University 845 Sherbrooke Street West Montreal, Quebec Canada H3A 2T5 Host institutions: ANCON Asociación Nacional para la Conservación de la Naturaleza Cerro Ancón, Calle Amelia Denis de Icaza Edificio No. 153 Quarry Heights Republic of Panama (507) Supervisors Ricardo A.de Ycaza Project and Research manager Yolani Holmes Authors Kesner Dabady Pierre Tulk 2

3 TABLE OF CONTENTS PRELIMINARY INFORMATION... LIST OF ACRONYMS USED...5 EXECUTIVE SUMMARY... 6 RESUMEN EJECUTIVO....8 HOST INSTITUTION GENERAL BACKGROUND ON THE PROJECT KEY CHARACTERISITCS OF PESTICIDES PESTICIDE IN PANAMANIAN AGRICULTURE HEATH ASPECTS OF PESTICIDE USE IN PANAMA.. 16 AGROCHEMICALS LEGISLATION IN PANAMA RINCÓN DE SANTA MARÍA CASE STUDY STUDY OBJECTIVES GENERAL OBJECTIVES SPECIFIC OBJECTIVES METHODOLOGY STUDY SITE PREPARATORY WORK DATA COLLECTION DATA ANALYSIS ETHICAL CONSIDERATION RESULTS/DISCUSSION OVERVIEW OF AGRICULTURE OVERVIEW OF HEALTH SURVEY LIMITATIONS AND FUTURE CONSIDERATIONS...37 CONCLUSION REFERENCES APPENDICES

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5 LIST OF ACRONYMS USED ANAM: Autoridad Nacional del Ambiente ANCON: Asociación Nacional para la Conservación de la Naturaleza COPANIT: Comisión Panameña de Normas Industriales y Técnicas CLICAC: Comisión de Libre Competencia y Asuntos del Consumidor IDIAP: Instituto de Investigación Agropecuaria de Panamá IPM: Integrated Pest Management MICI: Ministerio de Comercio e Industrias MIDA: Ministerio de Desarrollo Agropecuario MINSA: Ministerio de Salud MRL: Maximum Residue Limits OMS: Organización Mundial de la Salud PNUMA: Programa de las Naciones Unidas para el Medio Ambiente PPE: Personal Protective Equipment UNEP: United Nations Environment Programme WHO: World Health Organization 5

6 EXECUTIVE SUMMARY AGROCHEMICALS AND THEIR IMPACT ON HUMAN HEALTH: An analysis of pesticide use and incidences of diseases in the region of Rincón de Santa María Host Institution: ANCON Authors: Kesner Dabady and Pierre Tulk Heavy use of toxic pesticides in agriculture worldwide has raised serious concerns about health issues. The World Health Organization (WHO) estimates that acute pesticide poisoning (APP) affects 3 million people and accounts for 20,000 unintentional deaths per year, with 99 percent of these fatalities believed to be in developing countries. In Panama, several diseases related to pesticide poisonings have been reported. In El Rincón de Santa María in particular, a small town in the province of Herrera surrounded by vast industrial monocultures, farmers misuse pesticides and do not follow safety procedures for application despite being informed about negative health effects of these products. Consequently, both acute and chronic cases of pesticide-induced illness are common in this area. This research project therefore aims to examine the perception, knowledge and practices associated with the use of pesticides in the area of Rincón the Santa Maria, as well as the awareness of farmworkers with regard to the possible side effects of these chemicals on human health. This project was done over the course of four months, from January to April Several semi-structured interviews were conducted among government entities in the study area including MINSA and MIDA to obtain information pertaining to health and agriculture respectively. A survey questionnaire was also distributed among 30 farmworkers in the community to assess their knowledge, perception and awareness with regard to handling of pesticides. Out of the 30 questionnaires distributed, 20 were retrieved, for a response rate of 66%. Eleven (55%) of the respondents were men and 7 (45%) were women. The median age was 6

7 43 years (Q1= 36 years, Q3= 50 years). All of the respondents have had at least primary education, only seven (35%) had secondary education and none had attended post-secondary education. The surveys revealed that even amongst the agricultural workers who receive training on pesticide use, there seems to be a lack of information about the potential hazards of pesticides on health. The main sources of information for the workers were the MIDA, the pesticide vendors and the MINSA. The absence of traditional media as a source of information might indicate that public-awareness campaigns using these channels might be unlikely to reach the main actors (the agricultural workers). Although there seems to be a consensus in the respondents towards the necessity of more educational workshops, further clarification is needed in regard to the contents of these workshops in order to meet the needs and concerns of the farm workers. More in-depth face-to face interviews with the producers would allow the assessment of these needs and could be the entry point towards a more participatory education. Additionally, this study did not cover the perceptions and knowledge of the producers regarding the environmental impacts on pesticides. The integration of the environmental component to this study would help in building a holistic assessment of the agricultural situation in that region. 7

8 RESUMEN EJECUTIVO AGROQUÍMICOS Y SUS IMPACTOS EN LA SALUD HUMANA: Un análisis del uso de plaguicidas y de las incidencias de enfermedades en el Rincón de Santa María. Institución: ANCON Autores: Kesner Dabady and Pierre Tulk El uso intensivo de plaguicidas en la agricultura a nivel mundial ha planteado serias preocupaciones sobre los problemas de salud. El Organización Mundial del Salud (OMS) revisó las estimaciones globales de intoxicaciones agudas por plaguicidas a 3 millones de casos, con el 99 por ciento de estas muertes ocurren en países en desarrollo. En Panamá, se han reportado varias enfermedades relacionadas con intoxicaciones por plaguicidas. En El Rincón de Santa María en particular, un corregimiento en la provincia de Herrera rodeado de extensos monocultivos industriales, los agricultores abusan de pesticidas y no siguen los procedimientos de seguridad para su aplicación a pesar de estar informado sobre los efectos negativos de estos agroquímicos en la salud humana. En consecuencia, casos agudos y crónicos de enfermedades en relación con plaguicidas son comunes en esta área. Por lo tanto, este proyecto de investigación tiene como objetivo examinar la percepción, los conocimientos y las prácticas relacionadas con el uso de plaguicidas en la zona del Rincón de Santa María, así como la sensibilización de los trabajadores agrícolas en relación con los posibles efectos secundarios de estos productos sobre la salud. La metodología se extendió durante cuatro meses. Varias entrevistas semi estructuradas se realizaron entre las entidades gubernamentales en el área de estudio, incluyendo el MINSA y el MIDA, para obtener información relacionada con la salud y la agricultura, respectivamente. Además, se realizó una encuesta entre los trabajadores agrícolas en la comunidad para evaluar el conocimiento, la percepción y la conciencia de los campesinos con respecto a la manipulación de plaguicidas. De las 30 encuestas distribuidas, 20 fueron recuperadas, por un rato de participación de 66%. Once (55%) participantes eran hombres y 9 (45%) eran mujeres. La edad media era de 43 anos (Q1=36 anos, Q3=50 anos). Todos los participantes tenían primera educación, pero 8

9 solamente 7 (35%) tenían educación secundaria y ninguno tenía post-secundaria educación. Las encuestas mostraron que incluso entre los trabajadores que reciben educación sobre el uso de plaguicidas, falta información sobre los efectos adversos posibles de las plaguicidas por la salud humana. Las principales Fuentes de información para los trabajadores eran el MIDA, los vendedores de plaguicidas y el MINSA. La ausencia de los medios de comunicación convencionales (televisión, radio o Internet) como fuente de información puede indicar que las campanas de sensibilización que utilizan estos canales tendrían poco éxito para llegar a los actores principales. Aunque parece que hay un consenso entre los participantes sobre la necesidad de añadir más talleres de capacitación, necesita más clarificación sobre el contenido de estas iniciativas para atender a las necesidades y preocupaciones de los productores. Más entrevistas cara a cara serían necesarias para establecer esas necesidades y podría ser un primer paso para una educación participativa. Además, sería interesante incluir una perspectiva ambiental a este estudio y medir, por ejemplo, los conocimientos y las percepciones de los productores sobre los impactos ambientales de las plaguicidas. La integración de los componentes ambientales a este proyecto permitiría un enfoque integral de la situación agrícola de esta región. 9

10 HOST INSTITUTION The National Association for the Conservation of Nature (ANCON) is a Panamanian non-profit and non-governmental organization founded in 1985 by a group of prominent scientists, businessmen and community leaders. Its main mission is to conserve biodiversity and protect the natural resources of the country for the benefits of present and future generations. ANCON participates in the maintenance of many Panamanian national parks, such as the Parque Internacional la Amistad, the Parque Nacional Coiba, The Parque Nacional Chagres and the Parque Nacional Darien. ANCON also promotes the development of a variety of projects in relation to environmental conservation throughout the country. The domains include reforestation, promotion of microenterprises of ecotourism, sustainable tourism in coastal and island settings, cleaning of beaches & rivers, environmental education. ANCON s field of activity includes as well advice for the realization of management plans for protected areas, rapid ecological assessments and participatory rural appraisals. The scope of these projects spans across the entire country of Panama (and Costa Rica in the case of Parque Nacional la Amistad). The present project is in line with ANCON s philosophy towards the importance of education and community empowerment. We aim to target the miscommunication issues that can arise in educational initiatives in regard to pesticide use, and we are doing so by actively seeking the participation of the key stakeholders of the situation. With this investigation, we hope to provide useful information for further research in the rural area of El Rincón. 10

11 GENERAL BACKGROUND ON THE PROJECT Key Characteristics of Pesticides Pesticides are substances widely used worldwide to control different agents, among which are insects, arthropods, animals transmitters of diseases, fungi and plants. These products are used both in horticulture and crop systems (control of insects and weeds), on livestock (pest control), and in the public health sector to control disease vectors such as mosquitoes. Pesticides are sold worldwide and used both at industrial and domestic level. According to the latest estimates, approximately 2.36 billion kilograms of pesticides were used worldwide in 2007, producing a business worth of $40 billion USD this is a fiftyfold rise in the amounts of pesticides used internationally since 1950 (EPA, 2011). Patterns of pesticide consumption have been shifting as well in developing countries: their global share of pesticide use has doubled in the past three decades, going from 20% of 40% (PANNA, 2006). Particularly in the seven countries of the Central American Isthmus (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama ), there has been a steady increase in the use of pesticides, reaching its peak in 2001 with imports of 46 million kg of active ingredient, which are formulated in 42 plants in these countries (PAHO, 2004). Pesticides are a vital component of modern farming. About one-third of the agricultural products in the world are produced by using pesticides (Liu et al., 2002). Nonetheless, concerns about the impacts of these products on human health have increased over the past several years (Van der Werf 1996; Wilson and Tisdell 2001; Pimentel 2005). Exposure to dangerous pesticides due to inappropriate use or protection cause a wide range of negative health effects. Among the possible outcomes, acute poisonings are the most likely to be detected and have been identified 11

12 as a major health concern in the developing world (Kishi and Ladou, 2001). Acute pesticide poisoning (APP) or clinic cases is the severe poisoning which occurs after exposure to a single dose of pesticide. The appearance of symptoms may be sudden and dramatic or they may be delayed. Reported symptoms of acute pesticide poisoning include: fatigue, headaches, body aches, skin discomfort, skin rashes, feelings of weakness, circulatory problems, dizziness, nausea, vomiting, impaired vision, cramps, etc., and in severe cases, coma and death (M.C.R. Alavanja et al., 2004). Also, there is evidence that exposure to pesticides may cause chronic effects on health such as cancer (Kristensen et al., 1996; Hardell 2003; Gilden et. Al., 2010), interference with the development of children and fetus during pregnancy (Frederick, 1995; Sanborn et al., 2007) as well as disruption of the reproductive, endocrine, immune and central nervous system (Ascherio et al., 2006; Ismail AA et al, 2012). There are currently few reliable estimates as to how many people per year suffer from pesticide-related health effects. One of the latest estimates of acute poisoning cases worldwide was done by the WHO/UNEP Working Group on Public Health Impact of Pesticides Used in Agriculture in The global estimate for pesticide-related health effect was of 3 million cases of severe poisonings, with 99 percent of these fatalities occurring in developing countries (WHO, 1990). One must keep in mind that these estimates are based on hospital admissions and probably underestimate the actual number of pesticide poisonings. In fact, in developing countries where there is insufficient regulation, lack of surveillance systems, little to no enforcement and inadequate access to information systems, the incidences are presumed to be higher (IFCS, 2003). Studies from developing areas in Central America (El Salvador and Nicaragua) have indicated an overall incidence rate of 35 per for APP in the general population (Henao and Arbelaez, 2002). 12

13 Poisoning incidences in agriculture occur even more often as a result of careless handling of pesticides usually on the part of operator error due to wilful negligence, lack of information or lack of training (Koh and Jeyaratnam 1996; Reeves & Schafer 2003). For example, leakages from joints in the application equipment may often cause farmers to come into direct skin contact with large amounts of a pesticide. Similarly, clogged or unsuitable nozzles on the spraying equipment affect the quality of application and increase the degree of exposure. Changes in the wind speed and direction during spraying can result in pesticide absorption in the respiratory tract. Application on extremely hot and dry days promotes pesticide drift which also increases exposure. Spraying from the air can create a risk for farmers who are not involved in the operation, including the population at large. All the above situations which are common during pesticide application may result in direct and prolonged exposure of farmers to pesticides which may in turn affect their health. Farmers' knowledge of the potential hazards of pesticide handling is important for the prevention of exposure to these harmful chemicals. Levels of knowledge regarding routes of exposure to pesticides and specific health effects of pesticides may vary considerably among farmers. Studies conducted in the Gaza Strip reported high levels of knowledge on the health impact of pesticides (Yassin et al. 2002). Similarly, good knowledge about the acute health effects of pesticides and their exposure routes have been found among pesticide applicators in Ecuador (Hurtig et al. 2003). Moderate or low levels of knowledge about pathways of absorption of pesticides and of potential symptoms following exposure were found among farm workers in Egypt (Stewart 1996), and Ghana (Clarke et al. 1997). Chemical pesticides remain today the choice of many farmers despite the increase of pesticide-related diseases and the presence of alternative methods to control pest such as 13

14 biological control, genetic control and IPM, because they are cost-effective, easily available, and display a wide spectrum of bioactivity (De A. et al., 2014). Pesticide in agriculture in Panama The use of pesticides in agriculture in the country goes back to the 1930s, with intensive agricultural production activities such as banana production, sugar cane and livestock. The public health sector has also been making use of pesticides in vector control of tropical diseases, which began during construction of the Panama Canal in the early decades of the twentieth century (UNEP, 2000). The use of pesticides in the country particularly increased during the 1970s, when agriculture became mechanized as industrialization became more intensified (ibid.). At the beginning of the year 2000, Panama was the leader in Central America for the usage of pesticides per inhabitant and also in the amount of pesticides used in cultivated hectares (Table 1). The country imports an estimated 700 million tonnes of pesticides per year for an agricultural usage averaging three kilograms per capita (STRI, 2006). This is an amount more than six times higher than the international average, and nearly three times that of the Central American region (ibid.). Among the many reasons for the intensive use of pesticides in Panama, the most important are the influence of the industrial/commercial pesticides sector, the use of technology in the cultivation of monocrops, and the climatic conditions of the inter-tropical zone with high temperature and rainfall (UNEP, 2000). Crops that utilize the highest quantities of pesticides are fruits (such as banana, melon, pine and citrus), vegetables, grains (such as rice and corn), and sugar cane. 14

15 Díaz, Lamoth and Leonardo (1998) propose five other factors that explain the intense use of pesticides in the country: 1. The presence of an agricultural export model rooted in the paradigm that the restricted use of pesticide is a basis for obtaining competitive levels of productivity; 2. The political determination to be tied to the international markets, competing with the quality of exportable products, which necessarily implies an intensive use of pesticides; 3. The maintenance of high-scale banana production for exports, which requires high volumes of pesticides; 4. The increasing adoption of non-traditional cultures by small and medium producers, who uses agrochemicals more intensively. The author also notes that the dispersion of smaller producers, which own less than five hectares of land, makes it more difficult to implement ways of reducing pesticide hazards 5. The productive expansion of cultures for intern consuming such as rice, sugar cane, yucca, as well as the augmentation of bovine, porcine and poultry productions In general, pesticides enter the Republic of Panama from the United States, Europe and Japan as well as from Central America, Asia and Africa. Local manufacturing also allows export of pesticide, but imports remain greater in comparison to exports. 15

16 Health hazards of pesticides in Panama The inadequate use of pesticides may constitute one of the principal problems in public health in Panama (Díaz, Lamoth and Leonardo, 1998; Garcia, 1998). Díaz, Lamoth and Leonardo (1998) reviewed three independent studies quantifying the cases of APPs in the country: one is the Lic. Hildaura Patino on APPs registered at hospitals in the Republic in 1993 (with the exception of Bocas del Toro), another is the Mérida Diaz F. and Tristan da Brea L. 1992, which explores the APPs registered in the provinces of Chiriqui, Veraguas, Bocas del Toro and Panama during the period , and the last is Dr. Lucas E. Mora 1995 examining the records of the APPs in the Chiriqui province during the The studies revealed that cases of APPs were registered in the country during the period of Almost 40% of cases of APPs were in the age group of years and the male population tended to be more exposed and poisoned by pesticides (80%). The province of Chiriquí had the largest number of APPs, which was not surprising, considering the fact that agriculture is more present in that province. Factors who determine the toxicity of the pesticide include: the dosage, the time and duration of exposition, the route of entry into the body, the chemical structure of the component, and genetic particularities (Requena, 2009). In Panama, organophosphorus pesticides are one of the most common toxic agents causing negative health effects, as they inhibit the activity of the enzyme acetilcholinesterase which regulates the transmission of nervous impulses (ibid.). The active ingredient Paraquat, found in certain herbicides, accounted for 50% of the deaths related to pesticides in the decade Although this products was listed restricted by the MIDA 16

17 in 1999, kilograms were imported between the period of (Requena, 2009). Table 2 below shows the principal families of pesticides used in the country, as well as their effect on health. The latest data regarding cases of pesticide poisoning in Panama were published in The report, which was based on data of the programme of surveillance of APPs in Central America (PLAGSALUD 1 ), shows an increase in APPs in Panama: 3366 cases were registered during the period (Table 3). This number is thought to be higher considering that underreporting may exceed 80% of the cases according to statistics from (OPS / PLAGSALUD ). The main causes of underreporting often encountered are: difficulty in accessing 1 The project: Occupational and Environmental Aspects of exposure to pesticides in Central America (PLAGSALUD) is a project that aims to reduce acute poisoning by agrochemicals. Created in 1994, it is at the present time the only pesticide surveillance programme in Panama. 17

18 health services; lack of signs and symptoms of poisoning; misdiagnosis and administrative under-registration. At the present time, there are no published studies on cases of chronic pesticide-related diseases in Panama, mainly because their compilation entails long term and costly epidemiological studies to clearly assess the relation between continual exposure to pesticides and potential health effects (MINSA, 2011). Overview of the legal context surrounding pesticides in Panama The legislative context surrounding pesticides in Panama is of great complexity, involving several governmental and non-governmental institutions and agencies. The main government entity involved in the regulation of pesticide in the country is the Ministry of Agricultural Development (MIDA). This institution is responsible for the application of national policy on registration, distribution, storage, sale and use of pesticide, which is done through the National Directorate of Plant Protection (Act 47 of 9 July 1996) and the Directorate of Animal Health (Law 23 of July 15, 1997). There also exist a strong collaboration on the issue of pesticide disposal with the Ministry of Health (Decree 19 of April 10, 1997 on coordination between MIDA-MINSA and Decree 249 of June 3, 2008 on health standards for disposal of pharmaceutical waste and chemicals). 18

19 In 1997, because of international pressure and demand from Panamanian society, the National Directorate of Plant Protection, through Solved No. 74 of 18 September, approved to ban 61 pesticide active ingredients (see Annex). More recently, the use of Oxamyl (Solved No. 43 of 14 September 2011), of Chlorpyrifos (Solved No. 44 of 14 September 2011) and methomyl (Solved No. 41 of 13 September 2011) have also been restricted. Additionally, with the aim of reducing the negative impacts of pesticide use, MIDA recently elaborated the Resolute and Manual which regulates the Land-Base Application of Pesticides (Solved No. 42 of 14 September 2011). The manual introduces rules for the sale of red band pesticides (toxicological class Ia and Ib) (Appendix 2). It is stated in the document some restrictions on the application during bad weather conditions, the establishment of safety zones for the protection of critical areas, and required courses for pesticide applicators. The following is a brief list of other main government entities involved in the regulation of pesticide in the country: The Ministry of Health (MINSA) is mainly involved in the creation and maintenance of a national registry (Registro Sanitario de las Especialidades Farmacéuticas y productos similares) listing all the pesticides in the country and their toxicological information. This institution also establishes the maximum residue limits (MRLs) and produces norms for the safe use of pesticides both in domestic and industrial uses. The Ministry of Trade and Industry (MICI) regulates the commercialization and standardization of pesticides along with the CLICAC and the ANAM. It was also indirectly involved in the creation of specific norms in relation to the definition and classification, toxicology, sampling and preparation of analysis, labeling and packaging of pesticides. 19

20 Last but not least, the Agricultural Research Institute (IDIAP) which regulates the introduction of new pesticides, seeds, fertilizers and other products intended for the use of the agro-food sector in the country. The country also complies with international law on pesticide issues in regard to the resolutions and directives adopted at the Conferences of the Parties to the Stockholm and Rotterdam (ANAM 2012). The classification of pesticides in Panama also follows the recommendations of the WHO and includes 5 categories of risk according to their MRLs, as seen in Appendix 2. Rincón de Santa María case study Various cases of agrochemical-induced diseases have recently been reported in Rincón de Santa María, Herrera. In 2010, several children and teachers from this town had to be brought to the emergency of the hospital in Chitré because they were exposed to an aerial spraying of chemicals on a field of rice in Rincon (La Estrella, 2010). More recently, in 2014, the contamination of the Rio Villa with the pesticide atrazine, due to the negligence of the bioethanol company Campos de Pesé caused an uproar in the region after the water was declared undrinkable for a couple of days. Even though the chemical spill was declared accidental, the incident shed light on the lack of knowledge of the population regarding pesticides; several producers from the Herrera province admitted that they knew very little about safe methods of pesticide use (PanamaAmerica, 2014). El Rincón was therefore a zone of interest to measure the knowledge and perceptions of the farm workers towards pesticides. Furthermore, during our preliminary investigation in the field, we frequently witnessed farm workers misusing pesticides on the field and/or not following safety procedures for 20

21 application. Many were applying pesticides without personal protective equipment (PPE) such as gloves, waterproof pants and jackets, safety masks, etc. STUDY OBJECTIVES General objectives This project research aims to examine the perception, knowledge and practices associated with the use of pesticides in the area of Rincón de Santa Maria, as well as awareness of farmworkers with regard to the possible side effects of these products on health. Specific objectives 1- Do a general overview of agriculture in Rincón 2- Document the health status with regard to pesticides in the area 3- Conduct a survey on the use of pesticide among farmworkers in the community METHODOLOGY Study Site El Rincón is a corregimiento of the district of Santa María located north in the province of Herrera, at 225 km from Panama City. It is a small rural town (population of 1712 habitants according to the 2010 census) bordered by the lower reaches of the Rio Santa María. An estimated 90% of the inhabitants of El Rincón are involved in agriculture, either working for agricultural enterprises or for subsistence (Diaz L. Pers. Comm.). The territory is divided in many sub-localities including El Torno, Rodeo, Rio Escorto; and has a total area of 4000 hectares (INEC, 2010). The majority of the population lives along the main road and surrounded 21

22 by large industrial agricultural production. The main road is the only paved road, but several smaller dirt roads and tracks exist throughout the area. Preparatory work We conducted a preliminary press and literature review in order to familiarize ourselves with the context of the region in relation to pesticide use. Our first visit on the field took place in the end of January 2015 and had for objectives [1] to make a first assessment of the field conditions, [2] to elaborate a contact list for the following working sessions on the field and [3] to further develop the objectives and scope of the project. Introductory meetings were held during with several government authorities in order to present the research project and seek collaboration. We introduced ourselves at the offices of MIDA, MINSA and ANAM in Divisa, Santa Maria, El Rincón and Chitré, as they were thought to have the most access to farmers, as well as related information; they also served as a link to reach the community of our study site. We then visited a farm in El Rincón to established contact with the producers, and had the opportunity to interact with three farm workers. These interactions took the form of simple conversations and, in some cases, semi-structured. From this preliminary trip, we were able to define the main objectives of the project research and to create a list of contacts for further visits in the region. Data collection Agricultural and Health information Semi-structured interviews were conducted with agricultural technicians from the MIDA office in Divisa throughout the project. Since these individuals worked closely with farmers in Rincón, they were thought to be a good resource for learning about everyday issues and 22

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